MEDICARE: DR. RONALD LINDSEY UNDERHILL III D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH 10415	FL

General Provider Information

NPI Number	:	1043589302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD LINDSEY UNDERHILL III D.C.

Provider Business Mailing Address
First Line	:	314 CITRUS OPEN DR
Second Line	:
City	:	NEW SMYRNA BEACH
State	:	FL
Zip	:	32168-6194
Country	:	US
Telephone Number	:	386-690-0816
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 CANAL ST
Second Line	:
City	:	NEW SMYRNA BEACH
State	:	FL
Zip	:	32168-7009
Country	:	US
Telephone Number	:	334-655-8455
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2011
Last Update Date	:	05/15/2014

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